Research
Lipoprotein levels and cardiovascular risk in HIV-infected and uninfected Rwandan women
-
* Corresponding author: Kathryn Anastos kanastos@verizon.net
1 Montefiore Medical Center, Bronx NY, USA
2 Albert Einstein College of Medicine, Bronx, NY USA
3 TRAC Plus - Center for Treatment and Research on AIDS, Malaria, Tuberculosis and other Epidemics, Kigali, Rwanda
4 Data Solutions LLC, Bronx, NY USA
5 Stroger (Cook County) Hospital and Rush University, Chicago, Illinois USA
6 New York Medical College, Valhalla, NY USA
7 SUNY Downstate Medical Center, Division of Cardiovascular Medicine, Brooklyn NY USA
8 King Faisal Hospital, Kigali, Rwanda
9 Women's Equity in Access to Care and Treatment (WE-ACTx) and Kigali Health Institute, Kigali, Rwanda
AIDS Research and Therapy 2010, 7:34 doi:10.1186/1742-6405-7-34
Published: 26 August 2010Abstract
Background
Lipoprotein profiles in HIV-infected African women have not been well described. We assessed associations of lipoprotein levels and cardiovascular risk with HIV-infection and CD4 count in Rwandan women.
Methods
Cross-sectional study of 824 (218 HIV-negative, 606 HIV+) Rwandan women. Body composition by body impedance analysis, CD4 count, and fasting serum total cholesterol (total-C), triglycerides (TG) and high-density lipoprotein (HDL) levels were measured. Low-density lipoprotein (LDL) was calculated from Friedewald equation if TG < 400 and measured directly if TG ≥ 400 mg/dl.
Results
BMI was similar in HIV+ and -negative women, < 1% were diabetic, and HIV+ women were younger. In multivariate models LDL was not associated with HIV-serostatus. HDL was lower in HIV+ women (44 vs. 54 mg/dL, p < 0.0001) with no significant difference by CD4 count (p = 0.13). HIV serostatus (p = 0.005) and among HIV+ women lower CD4 count (p = 0.04) were associated with higher TG. BMI was independently associated with higher LDL (p = 0.01), and higher total body fat was strongly associated with higher total-C and LDL. Framingham risk scores were < 2% in both groups.
Conclusions
In this cohort of non-obese African women HDL and TG, but not LDL, were adversely associated with HIV infection. As HDL is a strong predictor of cardiovascular (CV) events in women, this HIV-associated difference may confer increased risk for CV disease in HIV-infected women.